Obituary

Martti Olavi Siirala, psychoanalyst and psychiatrist, and a dissident in terms of Finnish cultural life, died in Helsinki on August 18, 2008, at the age of 85. He was born in Liperi, eastern Finland, on November 24, 1922. This obituary outlines his life, professional career, and literary production.

were originally members of the Swiss Psychoanalytic Society under the International Psychoanalytical Association (IPA), they did not follow the IPA training instructions. Their teaching focused mainly on a psychoanalytic training circle, which Manfred Bleuler had incorporated into the university training at the Burghö lzli in 1950. From 1955 onwards, the bastion of Bally's and Boss's teaching was the Institut fü r ärztliche Psychotherapie, where Siirala also received his psychotherapist's diploma. Bally stayed closer to Freudianism than did Boss, who continued to develop Daseinanalysis, inspired by Heidegger.
Siirala's close ties with, for instance, Gaetano Benedetti, Norman Elrod, Fritz Meerwein, and Christian Mü ller, stem from his years in Switzerland. He also stayed in contact with Wilhelm Kü temeyer, Wolfgang Jacob, and Heinrich Huebschmann, who continued von Weizsäcker's work at the University of Heidelberg. Siirala's typewriter produced a remarkable number of letters to colleagues and friends, both near and far.
A path of his own and the forming of psychoanalysis As a psychoanalyst, Siirala sought a path and language of his own, and objected to existing doctrines and to shutting oneself within a specific school of thought.
Correspondence: Juhani Ihanus, Institute of Behavioural Sciences, Psychology, PO Box 9 (Siltavuorenpenger 1 A), FI-00014 University of Helsinki. E-mail: juhani.ihanus@helsinki.fi As he said in a conversation in as late as 1996 (personal communication, January 24): ''I am no Daseinanalyst, nor am I an existential analyst. I have my own perceptions and modes of therapy.'' He even sometimes doubted whether there was any sense in the term ''psychoanalyst'' at all. He also highlighted a lively and open dialogue between different schools of thought (Siirala, 1972): The doctrine and theory of an infallible system threatens to turn into a ritual and blind trust in science, where teachings smother that part of life towards which one should be open and unprejudiced. That is to say, that part of life that theory has largely been created to grasp. Theories do, however, tend to form to resemble dogmatic religious doctrines.
All this firm belief in dogmatic systems, Siirala (e.g. 1981b) called ''delusional possession of reality,'' or ''normal madness.' ' Siirala valued Sigmund Freud's life's work, and was faithful to Freud's idea of psychoanalysis as a continuously self-renewing field of study. Jung, however, remained considerably more distant to Siirala. According to Siirala, Freud never claimed he had created an infallible system: ''Freud became sensitive to hearing the plea of illness, staying faithful to this basic human challenge. . . . Exactly this birth of an essential contact and constant responsibility between the analyst and the analysand broke down barriers, and shaped in a whole new way the reality of humanity and mental distress for us to study even further'' (Siirala, 1999).
For Siirala, psychoanalysis was not some rigidly governed and defined doctrine, method, or perception of man; it was something that was only just ''on the way.'' Those who are involved in the ''arrival'' of psychoanalysis are, at the same time, ''co-responsible'' for it. Psychoanalysis is, then, ''what shape it takes, if we listen to the basic human message that speaks to us through it, and if we take part in that responsibility which belongs to us, as well as in the tasks to which it is awakening each one of us'' (Siirala, 1958).
The Therapeia Foundation, the first Finnish psychoanalytic training community The Therapeia Foundation was founded at the initiative of Martti Siirala and his theologian brother Aarne Siirala, as well as with the support of many Finnish intellectuals, in 1958. The Therapeia Foundation became the first organization and community for psychoanalytic training in Finland. Siirala was Executive Director of the Foundation from its establishment until 1971. He also acted as Chairman of the Board of Directors from 1971 to 1982, and as Honorary Chairman from 1983 onwards. Psychoanalysts and psychiatrists Allan Johansson and Kauko Kaila, who had studied in Switzerland, worked alongside Siirala as training analysts. Many European and American psychoanalysts also taught as visiting teachers. This created a strong basis for Therapeia's international quality right from the start. (For the history of the Therapeia Foundation, see Ihanus, 2000.) The first training group of psychoanalysts had the valuable asset of all three Finnish pioneer psychoanalysts participating in theoretical and clinical seminars. They each brought their own perceptions and questions to the shared discussion. This broadened and liberated the students' minds, and opened up the possibility of thinking about the theory and practice of psychoanalysis from different viewpoints and with different emphases. Psychoanalytic theories were also expanded in the direction of the visual arts and literature.
Thanks to Siirala's activeness, the Therapeia training seminars put an emphasis on international cooperation early on, and the Therapeia Foundation joined the International Federation of Psychoanalytic Societies (IFPS) in 1974. Siirala had already been present at the IFPS founding meeting in Amsterdam in 1962. As a member of the executive committee of the IFPS in 1977Á1984, Siirala brought forward Therapeian thought in the international context. Siirala was a member of the board of the International Federation of Medical Psychotherapy, as well as a member of the American Academy of Psychoanalysis. He was also on the editorial board of the following publications: Ehe, Human Context, Journal of the American Academy of Psychoanalysis, Journal of Communication Disorders, Spirali, and Vartija.

Congresses and general medicine studies
Siirala was appointed Docent of Psychiatry at the University of Helsinki in 1968, and honorary member of the Finnish Psychiatric Association in 1989. He taught and lectured on numerous national and international forums. If a theme of a congress inspired him, he would take part, no matter where the congress was being held. Siirala participated in international congresses from 1949 until the beginning of the new millennium. At the openings of some congresses, Siirala would take the floor and give surprise speeches that bypassed the official programme and have stuck firmly in the minds of many participants.
Von Weizsäcker, whom Siirala held in great esteem, had already defended ''bringing the subject into medicine.'' Siirala tried to reform the structure of basic medical studies from 1971 onwards, when he created a ''draft for general medicine studies'' . The studies connected with this draft did not start until 1978, but they expanded to cover the span of four terms of advanced courses. These courses, which supported the personal experience and development of students, were a part of the curriculum at the University of Helsinki for almost 20 years.
The subjects of Siirala's lectures included treatment knowledge, treatment liability, the message of illness, and the multidisciplinary cultural-philosophical ways of examining illness. There were also small discussion and study circles (e.g. in the fields of the psychotherapy of schizophrenia, psychosomatics, health-care politics, architecture, and image interpretation) that were largely started and run at Siirala's initiative and with his support. These groups in turn were the starting points for further stories and other productions by various people in different fields.
According to Siirala, those who were open to listening and sharing the human distress brought on by illness, and who were thus open to extended therapeutic dialogue, could be trained as psychoanalysts. He thought that medical doctors and psychologists were not entitled to a position of monopoly. Siirala emphasized the idea that psychoanalytic (professional) identity is an integral part of human (and personal) identity. On the perception of humanity and treatment at Therapeia he said that ''at least in principle, theory and methodology have had a not so strongly institutionalized protective purpose, that is, a less general defensiveness,'' which has made it possible to cherish the experience of ''there being hope after all'' (Siirala, 1993a).

Delusional possession of reality
Siirala's deliberations as a teacher of psychoanalysis and psychotherapy, as well as in his patient work, were fuelled by the following questions: ''What is the sense of being, what is the sense of illness in general and right now in relation to this person, in this therapeutic interaction that we are in? Physical and mental illness is a sane reaction to the problems of life a human being encounters'' (Siirala, 1986).
Psychotherapy is not about knowing in advance (''already''), but about helping to carry ''foreign'' (or actually one's own, repressed, displaced, or excluded) burdens of responsibility. Psychotherapy is not cramming what can be said about human experience into some ''thematization'' that is thought to somehow be primary, whether it is medical, psychological, sociological, or something else; instead, it is ''letting the demand, the plea of distress pull us with it at once'' (Siirala, 1958). Any preconceived and possessed attitude or position of dominant knowledge will obliterate the human perspective of understanding, and prevent us from awakening to hear and listen to the situation of our fellow human being.
Siirala sums up the basic idea of psychoanalysis and psychotherapy thus (quoted in Uurtimo, 2000): It is about a long-term and broadly responsible dialogue that strives to share the distress, suffering, helplessness, and feelings of being threatened that a human being might have. The goal is a sufficiently free perception of the self and finding meanings, which might lead one in the direction of understanding oneself, towards personal experience, towards becoming whole. . . . A trek in the patient's world shatters our attempts at a watertight theory, or generally our attempts at absolute knowledge, in other words at the delusional possession of reality.
This misguided practice of complete possession of reality and always being right Á which can also be called pride Á is fuelled by hubris, that is, deaf and blind self-assertion. Siirala's concept of hubris includes narcissism, which only wants itself and has no respect for others, but possessively takes over the other. According to Siirala, hubris is also ''the compulsion of a human to conquer the position of the highest, final judge of good and bad'' (Siirala, 1981a). In this compulsion, commanding knowledge takes the place of basic human trust.
Siirala noticed that one of the fundamental insights of psychoanalysis is incarnated in its ground rule, the instruction of free association. Its basic aim is ''to fight the deepest sediment of delusional possession of reality, hubris.'' (Siirala, 1981a; see also Siirala, 1997). Siirala also quoted Gustav Bally's (1961) perception, according to which psychotherapy is about two delusional worlds converging and shattering against each other. The delusion of ''normal'' and ''sane'' people is that they are free of all delusions.

In art, a human being is ahead of himself
The arts are strongly present in Siirala's thinking. Music, the visual arts, literature, film, and theatre were an integral element in his life, as well as in his theory-forming and teaching work. He himself was a performing artist; he enjoyed singing Schubert and acted in the Ma non troppo theatre group. Among other roles, he played Mr Martin in Ionesco's The bald prima donna, and the role of the King of Argos in The suppliants by Aeschylus. Siirala said that ''in art, a human being is ahead of him-/herself. The painful transformation into art is one way of changing what has collapsed on you into bearable history'' (personal communication).
The writers most dear to Siirala's heart were Dostoyevsky, von Kleist, Solzhenitsyn, Beckett, Camus, and Aleksis Kivi, painters included Brueghel the Elder and René Magritte, and the most important film director to him was Tarkovsky. René Magritte has pictured ''the meaning of a gaze and at the same time possessing with a gaze, the authority of the gaze, with a special illustrative quality''. In Siirala's (personal communication) interpretation, Brueghel realized that: each one of us is privy to full humanity, as well as a bearer of the suffering, guilt, and atonement that are part of it. ... In his painting Christ Carrying the Cross, the artist placed Jesus carrying his cross almost unnoticeably in a Dutch countryside landscape, in the middle of a wandering group of people and the everyday whirl of life. The message of the human identity has not been split or tied to the history and location of the time of Jesus. That message is constantly in a new setting, in new expressions and languages, staying in the spotlight.
Siirala also noticed that, in his film Solaris, Tarkovsky shows his audience 10 Brueghel paintings in the library of the space station, and stops in front of his Christ carrying the cross to peruse it for a long time. According to Siirala (1981a), Solaris sheds light on the faithÁknowledgeÁpower identification as a cognition of our time in an unbelievable way. The demand for a pure and infallible life means violence in itself.
Camus, according to Siirala (1981b), lets a fatal epidemic break out ''from the slow rotting of people and, on the other hand, the rotting of the relationship between human beings and their world.' ' Siirala (1981b) thought of The plague as ''a depiction of the uniformity of processes occurring on different levels of life, which is downright indispensable when trying to see the bigger picture, such as in the parallelism of biological and mental levels.'' Dostoyevsky spoke to Siirala as the writer of waste and suffering, but whose core of existence was, however, joy. ''In that, Dostoyevsky undoubtedly also embodies the core experience of the therapist. Without reasonable suffering, there would be no joy, either. This rescues us from a compulsive, false urge to place ourselves in the victim's position, which is our temptation as psychoanalysts and psychotherapists, too. Á To be, that includes joy' ' (personal communication, 1999).

Transfer
Siirala actively took part in the debate concerning the concepts of humanity and treatment. He emphasized the openness of human identity, as well as the communal responsibility connected to falling ill, and criticized medicine's blindness to the individual experience. The entire historical-social communal body was, according to Siirala, the ultimate starting point for all disorders or ''substitute burdens'' that individuals carry. These silenced, unprocessed burdens that are passed on from generation to generation and are often left unrecognized he also named ''transfers.' ' Siirala (1983; see also Siirala, 1993bSiirala, , 1997 saw an intergenerational chain of burdens and transfer networks being carried to, and unfolded in the analytic situation: The mission of a psychotherapist and psychoanalyst includes his or her acceptance of unconscious things, such as infringement of the basic rights of his or her patient, lies, deception, the lovelessness of the transfer network, the presence of delusional traditions Á all that has found a substitute target in the patient. The patient has been forced to carry this burden, and he or she has himself agreed to carry it and to express it in various mental and physical symptoms and disorders. This tradition has gone on from generation to generation.
In his musings on the core phenomenon of transference in the psychoanalytic and psychotherapy process, Siirala said that in that process, the chances at life that are about to be wasted are hatched out of the transfer package and, gradually, from transference. Healing in transference is based on the possibilities in the individuals themselves, hidden in the form of their distress. The observing of oneself and discovering connections of meaning takes a person toward the side of him or her that is about to be lost, which is now trying to be born again, and is looking for a new reception. Healing is ambivalent, and it meets with resistance. On the analyst's part, this process also means agreeing to suffer, to walk through traps and constructions of despair, in transference and in one's own countertransference.
As a legacy of the psychoanalytic training he received in Switzerland, Siirala brought the viewpoint of psychotherapy of somatic illness and psychosis as well as social pathology into both his own thinking and the training of the Finnish psychoanalyst and psychotherapist. This viewpoint takes us to the important part that therapeutic communities play in psychiatric and somatic hospitals, for example. Therapeutic communities are often reception areas for transfer in the form of communal transference.

International dialogue is an organic part of human beings
As early as the late 1950s, Siirala took part in the analysis of international conflicts and politics. Siirala always linked peace of mind closely with world peace. The ''all for me'' way of being, which excludes any annoying ''enemy,'' repeatedly proves to be a dead end between peoples. Siirala's comments on the stagnated power struggle between East and West that were born in the Cold War atmosphere again have a new resonance, although ideological codes have changed. In his article ''On peoples' life together'' (1957), Siirala reminded his readers of how different peoples have always shrouded and tangled their dealings in ''a web of blame and deceit'' and ''the doctrines of despair.'' He saw that East and West were not opposites divided by a chasm, but more like ''inseparable parts of a single whole, although demonically frozen in a state of dichotomy and opposition.'' The question Siirala posed deserves constant attention in the psychology of politics: ''Could the dichotomy of East and West be schizophrenia of the body of humanity, that is meant to be together, where the poles of that body cannot reach the real personal interaction so vital to it, but where they both prevent the realization and formation of their own and at the same time each other's true being and becoming, while frozen and bottled up in destructive mutual antagonism?'' (Siirala & Siirala, 1960).
Finland's problems in finding dialogue, friendship, and trust with the Soviet Union and later Russia have, according to Siirala, been a result of a lack of truthfulness. Being faithful to one's own essence has not come true in a spirit of genuine dialogue. Settling the traumas relating to national self-esteem requires reciprocal dialogue, not an irresponsible judgment of others.
Siirala defended setting right the injustices that the Finnish people had encountered, for instance in his book Syvissä raiteissa (In deep tracks) (Sirala & Kulonen, 1991), and with the Tartu peace movement. To Siirala, national self-esteem is not about raving nationalism or fanaticism in any way, or about the plight of Finland; it is about national culture being an organic part of humanity.

Publications
Martti Siirala (1995b) considers his texts having usually been sparked by ''being a part of some action,'' or as an attempt to rise to ''a challenge of connections that have unexpectedly opened up''. One such action was the long and intense dialogue with his theologian brother Aarne, which had already started in the second half of the 1940s and continued at its liveliest from the mid-1950s until the mid-1960s. Questions touching Christian tradition, as well as Lutheran, especially reformative Lundian, theology, were present in Siirala's writing at the time, but were cast aside in later writings.
Siirala's multifaceted literary output includes more than a hundred publications that deal with questions of psychoanalysis and psychotherapy, basic views on medicine, the treatment of schizophrenia and depression, psychosomatics, concepts of belief and knowledge, early developmental interaction, and communal problems. In his works Die Schizophrenie des Einzelnen und der Allgemeinheit (1961Allgemeinheit ( /2000, Medicine in metamorphosis (1969), and From transfer to transference (1983), Siirala has presented his highly original thought in condensed form. Many of his texts and unpublished lectures have remained unattainable to the general public, and they are yet to be catalogued into a bibliography. Siirala (1983) thought of his own baroque style of writing and of his ''obscurity'' as rising to the challenge of understanding; the reader should bear in mind ''that the most obvious matters of humanity that have been collectively forgotten do not have a ready-made place in general speech, even less so in scientific language. The way of speaking has, you see, organized itself into first forgetting those matters, and then into ensuring that they stay forgotten''. Siirala (1995b) did wryly comment on his style of writing: ''Warum es einfach zu machen, wenn es auch kompliziert geht! [Why make it simple when it can also be made complicated!].''

No berth for an anchor
Throughout his life's work, Martti Siirala pondered issues of truth and reality. He wrote that ''Truth is not something final, but it is in the process of becoming something and going in a certain direction. Truth is, for some part, also something that stops at the apparent. But we are involved in creating truth, which is partly shattering hopelessness and also producing hope'' (quoted in Uurtimo, 2000). Siirala repeatedly asked why we stop at one-dimensional truth and a nameless fate, and answered that we are afraid to see ''the horror of life, evil, and the powers of death'' (Siirala, 1995a). Multidimensional truth can be included in the sphere of common responsibility, when we want to discover the ''evil in us and our world.'' Siirala summed up his fundamental thoughts about reality in the following aphorism: ''Truth is fundamentally a secret, without a berth for an anchor that we could control'' (Siirala, 1995a).
In the words of the poet Gunnar Björling, whom Martti Siirala loved and who fuelled his thoughts (see Siltala, 2004): And all that we gave is all that we were and what we shall be known for. I shall grow beyond what I have said.